scholarly journals Allergic rhinitis during a coronavirus pandemic: difficulties of diagnosis and features of therapy

2020 ◽  
pp. 132-140
Author(s):  
O. V. Sebekina ◽  
E. V. Peredkova ◽  
N. M. Nenasheva ◽  
Yu. V. Grebennikova
Keyword(s):  
Allergic Rhinitis ◽  
Differential Diagnosis ◽  
Viral Infections ◽  
Respiratory Infections ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Diagnostic Methods ◽  
Intranasal Corticosteroids ◽  
Treatment Regimens ◽  
Short Period

Rhinitis can be of various etiologies. More often it is an infectious process (bacterial, viral) or clinical manifestations of an immediate allergic reaction. Other factors that provoke the development of rhinitis, for example, irritating substances, a number of drugs, hormonal imbalance, neurovegetative dysfunction, viruses are known. Doctors of various specialties are familiar with allergic rhinitis (AR) in their practice. In a number of cases there can be some difficulties in the differential diagnosis of rhinitis, the correct diagnosis and the appointment of adequate therapy. The COVID-19 epidemic (“coronavirus disease 2019”) has already been imprinted in the global history as an emergency of international importance. Scientific medical communities continue to study the characteristics of this epidemic, which is regarded by WHO as a pandemic. In a short period (from January 2020), there has been accumulated enough information about the etiology, features of the clinical manifestations of this disease, diagnostic methods have been developed, and clinical approaches and treatment regimens continue to be developed. The pandemic coincided with successive pollen seasons of trees, grasses and weeds. At the beginning of the pollen season, doctors were concerned about the possible difficulty in differential diagnosis of allergic rhinitis, manifestations of coronavirus and other viral infections. In the process of monitoring patients, more and more data has been accumulated, indicating the features of the clinical characteristics of COVID-19, influenza, acute respiratory infections, seasonal allergic rhinitis (rhinoconjunctivitis). Undoubtedly, information is still being accumulating and enriching day by day. AR is not only the most common form of rhinitis, but one of the most common diseases in children and adults. It is known about the pronounced negative effect of AR symptoms on the patient’s quality of life: normal daily activity, cognitive functions, mood, sleep. The severity of AR symptoms varies from minimal clinical manifestations to severe. Therapy should be directed towards the general control of AR symptoms. Over the past decades, the concept of phenotyping (definition of a disease by its clinical manifestations) and endotyping (based on the pathobiological mechanisms of the disease) has been developed. The belonging of AR in a particular patient to a certain phenotype plays a key role in choosing the most effective therapy and requires a personalized approach to treatment. The article provides frequently asked questions regarding AR treatment during the COVID-19 pandemic. The role of intranasal corticosteroids (InHCS), which are the most effective drugs in AR therapy, is discussed, due to their pronounced anti-inflammatory effect and influence on all stages of the pathogenesis of the disease. Mometasone furoate nasal spray has the widest indications among all InHCS drugs registered in our country.

scholarly journals Allergic rhinitis in children’s practice

2019 ◽  
pp. 192-197
Author(s):  
G. D. Tarasova ◽  
T. I. Garashchenko ◽  
Y. M. Sapozhnikov
Keyword(s):  
Allergic Rhinitis ◽  
Viral Infections ◽  
Clinical Manifestations ◽  
Severity Of Illness ◽  
Diagnostic Methods ◽  
Pediatric Practice ◽  
Distinctive Features ◽  
Therapy Regimen ◽  
Persistent Inflammation ◽  
Antihistamine Activity

Due to the prevalence of allergic rhinitis (AR) among the population of Russia, especially in pediatric practice, it is important today to give coverage to its clinical manifestations, principles of diagnosis, management of the patients and the possibilities to prevent exacerbations and increasing severity of illness. The authors provide the reasons behind why the intermittent AR has a persistent course. The article presents the diagnostic methods recommended in the ARIA documents. The authors note the important role of tight junctions in the nasal mucosa structure in protecting a person from aeroallergens and substantiate the rationality of prescribing systemic antihistamines to treat viral and a number of other types of infection. They also provide characteristics of minimal persistent inflammation and the distinctive features of local AR. According to the authors, the rationale for the use of complex treatment is the impossibility to completely cure AR. The article lists the activities and drugs included in the therapy regimen that is defined in the ARIA documents. However, the choice of a drug prescribed to the patient should be personified. The authors substantiate the prescription of systemic antihistamines in the development of acute respiratory viral infections caused by rhinovirus and give preference to Fenistil® due to the possibility of its use at an early age from 1 month in the form of syrup and drops as the most convenient dosage forms. The benefits of Fenistil® include: the speed of onset of a drug effect and its duration, high antihistamine activity and, as a result, pronounced itch relief, as well as the absence of a cardiotoxic effect, mild sedative effect, the ability of precise dosing and reduced production of nasal secretions. A clinical case with the rationale for the systemic use of this drug is presented. It is concluded that clinical data on the high efficacy and safety of Fenistil® entitle us to believe that its use is expedient, especially in pediatric practice.

Acute respiratory viral infections in COVID-19 pandemic in practice of polyclinic doctor

2021 ◽  
Vol 1 (11) ◽  
pp. 29-33
Author(s):  
V. V. Nikiforov ◽  
N. V. Orlova ◽  
V. V. Lomaychikov
Keyword(s):  
Differential Diagnosis ◽  
Viral Infections ◽  
Clinical Course ◽  
Respiratory Infections ◽  
Clinical Manifestations ◽  
Acute Respiratory Infections ◽  
Interferon Inducer ◽  
Coronary Syndrome ◽  
Respiratory Viral Infections ◽  
High Level

Acute respiratory viral infections (ARVI), including influenza, remain the most common infectious diseases. In the context of COVID‑19 pandemic, there is a need for differential diagnosis of respiratory syndrome. The clinic of ARVI, depending on the pathogen, may have its own characteristics. Influenza and COVID‑19 have common pathways of transmission of the pathogen and similar symptoms, so the optimal differential diagnosis is the use of test systems for both viruses. Against the background of influenza and other acute respiratory infections, complications from various organs and systems can develop. The article discusses in detail the issues of the clinical course of ARVI, differential diagnosis, modern approaches to therapyand prophylactic. Complications of influenza from the cardiovascular system are considered in detail. The data of our own observations on the risk of developing acute coronary syndrome in persons who have undergone COVID‑19 are presented. Prevention of the development of complications of influenza and other acute respiratory infections is the early appointment of antiviral therapy. Numerous studies confirm the effectiveness of interferon inducers in the treatment of influenza and other ARVI. The article presents the results of clinical studies confirming the effectiveness of therapy with the interferon inducer Kagocel. Against the background of its use, a decrease in the severity of clinical manifestations, a reduction in the duration of the disease, and the prevention of complications were noted. In studies, the drug has shown a high level of safety. The article discusses studies on the effectiveness of chemoprophylaxis of influenza and other acute respiratory infections.

Effectiveness of protected aminopenicillins in treatment of non-social pneumonia in children

2021 ◽  
Author(s):  
Е.Е. Краснова ◽  
В.В. Чемоданов ◽  
Е.Г. Кузнецова
Keyword(s):  
Viral Infections ◽  
Respiratory Infections ◽  
Acquired Resistance ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Severe Pneumonia ◽  
Physical Symptoms ◽  
Community Acquired Pneumonia ◽  
Natural Activity ◽  
Respiratory Viral Infections

Пневмония – острое инфекционно-воспалительное заболевание легких преимущественно бактериальной этиологии, характеризующееся выраженной в разной степени дыхательной недостаточностью, токсическими и респираторными нарушениями, локальными физикальными симптомами, а также инфильтративными изменениями на рентгенограмме. Заболеваемость внебольничными пневмониями повышается в октябре-декабре, достигая максимума в январе-апреле, коррелируя с сезонным повышением уровня острых респираторных вирусных инфекций. Схожесть симптомов дебюта пневмонии с проявлениями острых респираторных вирусных инфекций может привести к несвоевременной ее диагностике и, как следствие, к отсроченному началу лечения. Поэтому в период сезонной заболеваемости респираторными инфекциями должна повышаться настороженность врачей-педиатров в отношении внебольничной пневмонии. Антибактериальная терапия оказывает решающее влияние на прогноз пневмонии, поэтому при достоверном диагнозе или у больного в тяжелом состоянии с вероятным диагнозом ее следует начать незамедлительно. Выбор антибиотика в каждом случае внебольничной пневмонии проводят индивидуально с учетом природной активности препаратов в отношении предполагаемого возбудителя и их возможной приобретенной резистентности, тяжести и течения заболевания, наличия у пациента противопоказаний к использованию тех или иных антибиотиков. В статье приводятся сведения о диагностических критериях внебольничных пневмоний. Рассмотрены вопросы антибактериального лечения типичной нетяжелой пневмонии у детей разных возрастных групп амоксициллином с клавулановой кислотой и показана его эффективность. Результаты проведенного исследования позволяют заключить, что пероральное использование одного курса защищенного аминопенициллина эффективно при лечении типичной внебольничной нетяжелой пневмонии у детей разного возраста, о чем свидетельствует ликвидация основных клинических проявлений болезни в короткие сроки. Pneumonia is an acute infectious and inflammatory lung disease of predominantly bacterial etiology, characterized by respiratory failure, toxic and respiratory disorders, local physical symptoms, and infiltrative changes on the roentgenogram. The incidence of community-acquired pneumonia increases in October-December, reaching a maximum in January-April, correlating with the seasonal increase in the level of acute respiratory viral infections. The similarity of the symptoms of the onset of pneumonia with the manifestations of acute respiratory viral infections can lead to its untimely diagnosis and, as a consequence, to a delayed start of treatment. Therefore, during the period of seasonal morbidity with respiratory infections, the alertness of pediatricians in relation to community-acquired pneumonia should increase. Antibiotic therapy has a decisive influence on the prognosis of pneumonia, therefore, with a reliable diagnosis or in a patient in serious condition with a probable diagnosis, it should be started immediately. The choice of antibiotic in each case of community-acquired pneumonia is carried out individually, taking into account the natural activity of the drugs in relation to the alleged pathogen and their possible acquired resistance, the severity and course of the disease, the patient's contraindications to the use of certain antibiotics. The article provides information on the diagnostic criteria for community-acquired pneumonia. The issues of antibacterial treatment of typical non-severe pneumonia in children of different age groups with amoxicillin with clavulanic acid are considered and its effectiveness is shown. The results of the study allow us to conclude that the oral use of one course of protected aminopenicillin is effective in the treatment of typical community-acquired non-severe pneumonia in children of different ages, as evidenced by the elimination of the main clinical manifestations of the disease in a short time.

scholarly journals Dynamic neuropathy of the common peroneal nerve at the level of the fibular head (literature review and case report)

2019 ◽  
Vol 21 (1) ◽  
pp. 54-59
Author(s):  
M. G. Bashlachev ◽  
G. Yu. Evzikov ◽  
V. A. Parfenov ◽  
N. B. Vuitsyk ◽  
F. V. Grebenev
Keyword(s):  
Ankle Joint ◽  
Peroneal Nerve ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Common Peroneal Nerve ◽  
Diagnostic Methods ◽  
Fibular Head ◽  
Study Objective ◽  
The Common ◽  
The Right

The study objective is to report a case of dynamic neuropathy of the common peroneal nerve at the level of the fibular head and to discuss diagnostic methods and neurosurgical treatment. Materials and methods. We report a case of dynamic neuropathy of the common peroneal nerve at the level of the fibular head in a female patient. The patient was treated in the Neurology Clinic of I.M. Sechenov First Moscow State Medical University. We analyzed clinical manifestations and compared them with the data described in research literature. Results. Upon admission, the patient complained of pain in the anterolateral surface of the right shin and in the dorsum of the foot during walking. At rest, the patient experienced no pain. We observed no motor or sensory disorders typical of nerve root disorders at the level of L5. Lasegue’s test was negative. The patient had a positive Tinel’s sign in the area of the right fibular head. In order to clarify the diagnosis, we performed a repeated extension test in the right ankle joint and it was positive. The patient underwent surgery that included peroneal nerve decompression and neurolysis at the level of the fibular head. In the postoperative period, the patient had complete pain relief. Conclusion. Due to the difficulties in the diagnostics of dynamic neuropathy of the common peroneal nerve, this disease is often mistaken for radiculopathy at the level of L5. Thorough clinical examination, testing for Tinel’s sign in the area of the fibular head, and repeated extension test in the ankle joint ensure the correct diagnosis and reduce the frequency of ineffective surgeries on the lumbar spine. Surgical decompression of the common peroneal nerve at the level of the fibular head with obligatory opening of the entrance to the nerve canal is an effective method of treatment in such patients.

scholarly journals Recurrent respiratory viral diseases and chronic sequelae due to dominant negative IFIH1

2020 ◽  
Author(s):  
Christin L Deal ◽  
Timothy J Thauland ◽  
Rebecca Signer ◽  
Stanley F Nelson ◽  
Hane Lee ◽  
...  
Keyword(s):  
Viral Infections ◽  
Respiratory Infections ◽  
Clinical Manifestations ◽  
Dominant Negative ◽  
Dominant Negative Effect ◽  
Compound Heterozygous ◽  
Loss Of Function ◽  
Negative Effect ◽  
Respiratory Viral Infections ◽  
Compound Heterozygous Variants

Viral respiratory infections are the most common childhood infection worldwide. However, even common pathogens can have significant consequences in the context of patients with primary immunodeficiency diseases. More than half or viral infections annually are due to rhinovirus/enterovirus strains. Most clinical manifestations of viral infection are mild. However 3% of cases result in hospitalization in patients who have no other known risk factors. These patients may have an inborn error of immunity, a genetic susceptibility to viral infections. Here we present the case of an adult male who suffered respiratory viral infections his whole life and developed chronic, inflammatory damage to sinuses and lungs as a consequence. Genomic sequencing identified compound heterozygous variants in the IFIH1 gene, encoding the protein Melanoma Differentiation Association Protein 5 (MDA5), a RIG-I-like cytoplasmic sensor of RNA intracellular infections. We show a dominant negative effect on these variants on the level of interferon-induced expression of MDA5 protein. This work supports that loss-of-function variants in IFIH1 affect the sensing of viral infections. Underlying genomic variants may dictate the point at which recurrent, respiratory viral infections leave commonplace experience and incur lasting damage.

scholarly journals The treatment of allergic rhinitis improves the recovery from asthma and upper respiratory infections

1995 ◽  
Vol 113 (5) ◽  
pp. 968-972 ◽  
Author(s):  
Willy Sarti ◽  
Lídia Alice Gomes-Monteiro ◽  
Claudia Saad Magalhães Machado
Keyword(s):  
Allergic Rhinitis ◽  
Bronchial Asthma ◽  
Beclomethasone Dipropionate ◽  
Viral Infections ◽  
Respiratory Infections ◽  
Disodium Cromoglycate ◽  
Upper Respiratory Tract ◽  
Asthmatic Children ◽  
Upper Respiratory Infections ◽  
Upper Respiratory

Forty-six asthmatic children with repeated respiratory infections presented symptoms of allergic rhinitis. All patients were treated locally for allergic rhinitis either with disodium cromoglycate or beclomethasone dipropionate. After six months of treatment, 95% of the children showed improvement of allergic rhinitis and 84% improvement of bronchial asthma, as well as fewer infections. We concluded that allergic rhinitis plays an important role in facilitating infections of the upper respiratory tract, and a possible association of rhinitis, viral infections and bronchial asthma is discussed.

scholarly journals A Case Report of Bullous Emphysema in an Adolescent: Congenital Malformation or Outcome of Bronchopulmonary Dysplasia?

2020 ◽  
Vol 2 ◽  
pp. 2-6
Author(s):  
Svitlana Ilchenko ◽  
Anastasiia Fialkovska ◽  
Oleksii Makoveychuk
Keyword(s):  
Differential Diagnosis ◽  
Clinical Case ◽  
Diagnostic Method ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Detailed Examination ◽  
Pathological Process ◽  
Pulmonary Diseases ◽  
Chronic Obstructive ◽  
Chronic Obstructive Pulmonary Diseases

Pulmonary emphysema belongs to the group of chronic obstructive pulmonary diseases, and inpediatric pulmonology is one of the complex diagnoses that require a careful differential diagnosis. Thearticle describes the possible causes of the formation and clinical manifestations of pulmonaryemphysema in children. We present a clinical case of bullous emphysema in a teenager. This case showsthat a detailed examination using such a modern diagnostic method as high-resolution computedtomography played a crucial role in establishing the patient's correct diagnosis. However, establishing thenature of this pathological process in the child was very difficult. Perhaps an earlier diagnosis couldprevent severe irreversible changes in a teenager's lungs would avoid developing the diffusebronchopulmonary process.

scholarly journals Infectious Alertness in Removal Benign Neoplasms in the Maxillofacial Area

2020 ◽  
Vol 5 (5) ◽  
pp. 236-241
Author(s):  
V. N. Yadchenko ◽  
◽  
I. O. Pohodenko-Chudakova ◽  
E. S. Yadchenko ◽  
◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Soft Tissues ◽  
Subcutaneous Tissue ◽  
Clinical Manifestations ◽  
Diagnostic Methods ◽  
Benign Neoplasms ◽  
Humid Climate ◽  
Maxillofacial Region ◽  
European Continent ◽  
Surgical Interventions

Human dirofilariasis is a parasitic disease, transmissible helminthiasis caused by parasitizing nematodes of the genus Dirofilaria, most often D. repens and D. immitis which occurs with a predominant lesion of the skin (63%), conjunctiva (50%), mucous membranes, subcutaneous tissue and less often – internal organs. The most frequent incidence of dirofilariasis is observed in regions with a warm, humid climate, and at temperatures below 14℃, dirofilariae stop developing. Human cutaneous dirofilariasis on the European continent is most often diagnosed in representatives of southern and eastern Europe. There are confirmed cases of dirofilariasis on the territory of the Republic of Belarus and neighboring countries. Quite often, this disease affects the maxillofacial region. The purpose of the work was to initiate infectious alertness when planning operations for the removal of benign neoplasms in the maxillofacial region and inform medical specialists about the possibility of developing dirofilariasis of the specified localization, its clinical manifestations and objective diagnostic methods. Material and methods. The object of observation was a 34-year-old female patient R. with maxillofacial dirofilariasis. The subject of the study is the medical record of an inpatient patient R. Results and discussion. At the pre-hospital stage, patient R. underwent a general clinical examination. All indicators of the tests were within the age norm. According to the results of radiation examination methods, no data confirming the parasitic etiology of the disease was obtained. Taking into account the presence of a rounded formation about 1.0-1.2 cm in diameter which is slightly displaced relative to the underlying and surrounding soft tissues, the patient was offered surgical treatment. During the operation, a rounded self-moving helminth was extracted from the formation, about 11.0 cm long and 0.15 cm in diameter. After the helminth was identified, the patient was diagnosed with dirofilariasis. This should be taken into account in the diagnostic and therapeutic aspects when working with patients who have tumor processes in the maxillofacial region. Conclusion. The presented clinical observation shows that in the practice of a dental surgeon and a maxillofacial surgeon, it is increasingly possible to deal with the localization of helminth in the maxillofacial region which simulates a neoplasm which must be taken into account when conducting diagnostics, differential diagnosis and preoperative preparation. The results of the described case are aimed at developing infectious alertness when planning surgical interventions to remove benign neoplasms in the maxillofacial region, developing a rational diagnostic scheme and differential diagnosis for patients with suspected dirofilariasis and other parasitic lesions of the maxillofacial region

scholarly journals Sudden death associated with bleeding into digestive system of finishing pigs – a review

2021 ◽  
Vol 90 (1) ◽  
pp. 35-46
Author(s):  
Jaroslav Novotný ◽  
Peter Reichel ◽  
Petronela Kyzeková ◽  
René Mandelík
Keyword(s):  
Differential Diagnosis ◽  
Sudden Death ◽  
Digestive System ◽  
Clinical Manifestations ◽  
Gastric Ulcers ◽  
Economic Losses ◽  
Finishing Pigs ◽  
Pathological Changes ◽  
Constant Attention ◽  
Short Period

Sudden deaths of finishing pigs in modern pig herds cause economic losses and therefore draw constant attention worldwide. In the case of peracute mortality associated with gastrointestinal bleeding, pigs usually die during a short period without clinical manifestations. Necropsy can detect bleeding into various parts of the digestive system. Determining the exact aetiology of the sudden death can be difficult in many cases. Diseases and conditions such as gastric ulcers, abdominal torsion, haemorrhagic bowel syndrome and infectious diseases should be taken into account in the differential diagnosis. Because some of these diseases still have an unclear aetiology and pathogenesis, the aim of our work was to provide a summary of existing knowledge as well as to describe related pathognomonic pathological changes.

scholarly journals The bacteriological research in case of acute respiratory infections: actual, informative and effective

2018 ◽  
Vol 22 (2) ◽  
pp. 394-397
Author(s):  
S. I. Klymnyuk ◽  
L .B. Romanyuk ◽  
L .A. Volianska ◽  
E .I. Burbelа ◽  
N. Ya. Kravets ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Viral Infections ◽  
Respiratory Infections ◽  
Family Doctor ◽  
Clinical Manifestations ◽  
Risk Groups ◽  
Symptomatic Therapy ◽  
Acute Respiratory Infections ◽  
Family Doctors ◽  
Opportunistic Bacteria

The most common nosology in the routine work of family doctors is acute respiratory infections. The etiological composition of the acute respiratory viral infections is changing from year to year, which causes difficulties with the use of treatments. Purpose - improvement of tactics of a family doctor for antibiotic therapy of acute respiratory infections. Clinical manifestations of all etiological forms of ARI are similar, which complicates their differentiation. One of the leading - respiratory syndrome, is determined by the local defeat of certain parts of the respiratory tract. The pathogens of these diseases are mainly viruses, but the role of bacteria is also indisputable. According to the results of bacteriological studies with ARI, pathogens often include opportunistic bacteria of the staphylococcus group, streptococci, other aerobic and anaerobic cocci, representatives of the intestinal group and Candida, which can cause antibiotic-resistant forms. The family doctor should establish the diagnosis of respiratory infections, solve the problem of symptomatic therapy and agree on a strategy for the appointment of antibiotics. Most acute respiratory infections even in the absence of antibiotic therapy are recovering. Therefore, the tactics for the appointment of antibiotics should be determined depending on the severity of the disease, the belonging of the patient to certain risk groups. It would be advisable to include the collection of information on previous bacteriological studies and the preliminary history of the use of antibacterial agents, which would allow a family doctor to be better targeted when prescribing antibiotic therapy. The algorithm of the physician's action in the case of acute respiratory infections should be expanded at the point of coordination of the strategy of antibiotic therapy, adding to it the purpose of bacteriological examination in each case of diagnosis of ARI.

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